MOAA’s 2020-21 TRICARE Guide: Why Is Protecting Health Care Benefits a Challenge?

MOAA’s 2020-21 TRICARE Guide: Why Is Protecting Health Care Benefits a Challenge?
Toni Smith/U.S. Geological Survey

Editor’s Note: This article is part of MOAA’s 2020-21 TRICARE Guide, brought to you by MOAA Insurance Plans, administered by Association Member Benefits Advisors (AMBA). A version of the guide appeared in the November 2020 issue of Military Officer magazine.


Military service can be arduous, both for servicemembers and their family members. Health care and education benefits are two of the primary reasons most Americans decide to serve in the armed forces.


However, protecting TRICARE fees is difficult because senators and representatives in Congress (and their staffers) know what employers and civilians pay for their health care.


Even though this is an “apples to oranges” comparison, this is the major challenge MOAA and The Military Coalition (TMC) face when protecting the earned health care benefit.


[TRICARE GUIDE: What Happens When I Retire?]


In 2020, the average annual employer-provided family health care plan cost was $21,342. The employee was required to pay $5,588 of that amount in annual premiums (about $466 per month). That amount does not include any deductible and/or co-pays the employer plan may require.


Under TRICARE Prime and Select, the 2020 maximum out-of-pocket fee (catastrophic cap) for retirees with spouse and children is $3,000.  


Retirees who enroll in Prime at a military treatment facility (MTF) typically only pay the $600 TRICARE Prime enrollment fee (family rate) unless they are referred off base to a civilian medical facility, as all services at the MTF come without a co-pay.


The other major challenge is that DoD health care budgets have remained constant for the last 50 years — at 10% of the overall DoD budget. Yet every dollar DoD can avoid spending on health care can be diverted to acquisition programs (weapon systems) and operations.


MOAA and TMC will continue to fight against disproportional TRICARE fee hikes.


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About the Author

Capt. Paul J. Frost, AFC®, USN (Ret)
Capt. Paul J. Frost, AFC®, USN (Ret)

Frost co-leads MOAA's Financial and Benefits Education program and is also an accredited Veteran Service Officer (VSO), providing VA disability compensation claim and appeal information and advice to the military community.